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SAN DIEGO -- While women are boosting their numbers in the thoracic surgery specialty and making inroads into leadership, they haven't made corresponding gains in producing or presenting research in the field, researchers said here at the Society of Thoracic Surgeons' (STS) annual meeting.

Examining STS's own practices, Jacqueline K. Olive, a medical student at Baylor College of Medicine in Houston, and colleagues, analyzed the authorship of studies that were presented orally at the ATS annual meetings in 2015 and 2018. The percentage of male authors remained steady at 89% in 2015 and 90% in 2018, and there was little difference over time in the gender gap among presenting and senior authors, specifically.

"True diversity requires integration into leadership and academics," said Jessica S. Donington, MD, MSCR, former president of Women in Thoracic Surgery, in an interview. However, "change like this is slow," added Donington, who is professor and chief of thoracic surgery at the University of Chicago.

According to Olive, the Association of American Medical Colleges reported that women accounted for about 24% of cardiothoracic residents and fellows in 2017 and 7% of practicing surgeons. Those numbers are up from about 9% and 3% just 10 years earlier, Olive said in an interview, but they still rank near the bottom compared to other surgical specialties.

Still, women have made progress in important areas within STS. The number of female editorial board members for the society's flagship journal, , grew from four (5%) in 2015 to 14 (16%) in 2018, and the number of women in nominated STS leadership positions grew from 44 in 2015 (9%) to 82 (13%) in 2018.

Changing attitudes may be boosting these numbers. There's general agreement that "increased diversity and inclusion of women and underrepresented minorities is essential for success of the specialty," Donington said.

Why does the gender gap persist? "Although women now occupy more positions at each level of training, our data suggests that the growth in female representation in cardiothoracic surgery decreases with increasing academic rank," Olive said. Also, she said, research has suggested that women cardiothoracic residents are less interested in research than their male counterparts.

Donington said increased female representation on editorial boards and in leadership are important steps in making further progress throughout the specialty.

As for Olive, she called for boosting career advancement by "broadening scholarship and other high-profile opportunities for early- and mid-career female cardiothoracic surgeons at the STS Annual Meeting and other conferences; supporting research activities of women in the field by increasing protected research time, intentionally seeking out women collaborators, particularly junior female faculty; critically evaluating our review processes of abstract and manuscript submission; and maintaining the dialogue and momentum surrounding these issues."

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